Eyelid surgery at VCA AVCC in Fishers, IN is sometimes needed to correct a variety of problems associated with the eyelids. The most frequent causes of eyelid abnormalities requiring surgery include entropion, ectropion, distichiasis, ectopic cilia, trichiasis, eyelid masses, and lacerations. Many of these conditions, if left untreated, can cause chronic discomfort, corneal ulceration or in extreme cases blindness. Our Ophthalmologists will explain the problem as well as the procedures used to correct it.
Entropion is the inward rolling of all or part of the eyelid and can affect anywhere from one to all four of the eyelids. The result of this eyelid inversion is secondary rubbing of eyelid hairs on the corneal surface. This creates chronic irritation resulting in profuse tearing, squinting or corneal ulcerations which can compromise your pet’s comfort and eye health.
Surgery involves removing a small area of the eyelid to either shorten the length or evert the eyelid. In general, surgery is successful in nearly 90-95% of cases. The likelihood of needing a second surgery may be associated with younger age.
Ectropion is the outward rolling of the eyelid margin, or drooping appearance of the eyelids. This is commonly seen in dog breeds with heavy skin folds like Bloodhounds, Great Danes, Mastiffs, etc. Ectropion can also be seen in any dog or cat breed that has secondary scarring of the eyelids from a previous trauma.
Ectropion can cause ocular irritation due to excessive exposure of both the cornea and conjunctiva. There are surgical procedures where eyelid skin can be transposed or tension can be removed to reduce the “droopy” appearance and provide more protection to the surface of the eye. Ectropion surgery is not as common as entropion surgery and can, in some instances, be more complicated.
These conditions refer to eyelash hairs growing from an abnormal location. Most eyelashes should grow right on top of the upper eyelid margin, but in cases of distichiasis, the eyelashes grow through the eyelid margin. With ectopic cilia, hairs grow through the inner surface of the eyelid and are normally short and stubby, leading to significant discomfort and corneal ulceration.
For treatment, patients are placed under anesthesia, evaluated under an operating microscope, and abnormal hairs are removed. Recovery is usually quick, within 1-2 weeks. Common complications include swelling and depigmentation of the eyelid margins. Recurrence of distichia is possible, requiring a repeat procedure.
Trichiasis is a common ophthalmic abnormality associated with normal periocular hairs contacting the corneal surface. This is most commonly seen in brachycephalic breeds like Shih Tzus, Lhasa Apso, Bulldogs, Chihuahua, etc., with hairs near the inner corner of the eye contacting the cornea. Liquid nitrogen cryotherapy can be performed to remove the hair and prevent regrowth. Repeat procedures may be required based on the severity of trichiasis.
Eyelid mass removals are one of the most common procedures performed by ophthalmologists. The most common types of eyelid masses in dogs include: Meibomian gland adenoma, melanoma, and papilloma. Eyelid masses are typically benign in dogs, but they may have more malignant potential in cats.
In some cases where the eyelid mass is small and not causing ocular discomfort, monitoring may be recommended.
If the mass is larger but still less than 1/3 of the eyelid margin length or if a mass were to grow back after excision and cryotherapy, surgical excision under general anesthesia may be recommended. This is a straightforward procedure, which aims to remove the mass along with a small amount of healthy tissue to ensure clean margins and minimal risk of recurrence. The eyelid defect is placed together with sutures that will require removal in 2 weeks. Complications include loosening of sutures, infection, inflammation, regrowth of the mass, and corneal ulceration.
If the mass is >1/3 the eyelid length, a more complex removal and eyelid reconstruction will be discussed.
Eyelid lacerations are traumatic tears in the eyelid, commonly from animal injuries or injuries from sharp objects around the house or outside in the yard. When the eyelid margin is involved, surgical repair may be indicated. Any defect in the eyelid margin can lead to tear film disruption, ocular irritation, corneal ulceration, and loss of appropriate eyelid function. If surgery is recommended, the affected area will be cleaned and shaved, and any devitalized tissue will be removed. Following repair, complications associated with eyelid laceration include infection, wound dehiscence, change in appearance of eyelid margin, reduced eyelid function, and the need to repeat laceration repair. These patients are often sent home on both topical and oral antibiotics.
“Cherry eye” is a common term for prolapsed gland of the third eyelid. If the gland is not properly addressed, it will become inflamed and desiccated—this can lead to dry eye disease, conjunctivitis, and in progressed cases, severe corneal ulceration.
Surgical replacement of the gland is always recommended over removal.
Learn more about Cherry Eye in dogs: clinical signs, treatment options, and prognosis.
The cornea is the transparent, protective outer layer of the front of the eye. It is essential to maintain this structure for an appropriate vision. Because the cornea is less than 1 mm in thickness, it is very delicate and susceptible to damage.
Occasionally, surgery is necessary to repair the cornea. Some of the more common problems treated surgically are deep corneal ulcerations, corneal perforations, lacerations, corneal sequestrum, corneal/limbal tumors, and dermoids. These surgeries require equipment only used by our ophthalmologists. These include a high magnification operating microscope as well as specialized suture material and fine microsurgical instruments.
We tailor each procedure to your pet’s specific condition, ensuring individualized care and close follow-up throughout the healing process.
Learn more about corneal issues, including corneal ulcers in dogs and cats.